Objective To explore the clinical features of multiple organ dysfunction syndrome in the elderly (MODSE) induced by pulmonary infection in the patients over 80 years old. Methods A retrospective study was carried out on 97 patients over 80 years old with MODSE induced by pulmonary infection in our department from January 2006 to December 2013. Their chronic diseases and involved damaged organs were analyzed. Results Among the 97 cases, 97.94% were accompanied with more than 3 chronic diseases, and some even were accompanied with 10 chronic diseases. There were 12.37% cases at early failure stage and 87.63% at the failure stage. There were 45.36% cases having more than 4 involved organs, and some even had 6 damaged organs. Lungs, heart, kidneys, peripheral circulation and gastrointestinal tract were commonly damaged, and the lungs were the most common, accounting for 87.63%. In the damaged organs, more than 90% of the lung, heart, gastrointestinal tract and peripheral circulation were at the failure stage. The first failure organ of MODSE induced by pulmonary infection included lung, heart, kidney and gastrointestinal tract in the cohort, and the lungs took first rank. The incidence of first failure of certain organ was higher in the patients with organ dysfunction than those with normal organ function (P＜0.05). Conclusion MODSE induced by pulmonary infection in the patients over 80 years old is characterized with more chronic diseases, damaged organs, and serious damage. The lungs are the most commonly involved first failure organ, and the other dysfunction organs also have higher rates of first failure.